What Is the Medicare Formulary List?


Quick Answer

A Medicare formulary is a list of prescription drugs covered by a particular Medicare Prescription Plan. The Medicare Prescription Drug Benefit, known as Medicare Part D, subsidizes the cost of prescription drugs for Medicare recipients.

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Full Answer

Each Medicare Prescription Plan has its own formulary. Formularies are generally organized into tiers reflecting the required co-payment. The tiers range from the lowest cost generic drugs to preferred drugs, to the highest cost non-preferred and specialty drugs. Plans can revise their list of covered drugs during the year, but they must provide at least 60 days notice to affected persons. If a prescribed medication is not on a plan's formulary, the patient or the health care provider can contact theMedicare drug plan to request an exception.

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